Provider Demographics
NPI:1508291063
Name:C BREEZE FAMILY CARE CENTER
Entity Type:Organization
Organization Name:C BREEZE FAMILY CARE CENTER
Other - Org Name:C BREEZE HOME CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:W
Authorized Official - Last Name:STEWART-BREEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-350-1503
Mailing Address - Street 1:PO BOX 4174
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-0902
Mailing Address - Country:US
Mailing Address - Phone:336-350-1503
Mailing Address - Fax:
Practice Address - Street 1:2463 N CHURCH ST TRLR 39
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-3257
Practice Address - Country:US
Practice Address - Phone:336-350-1503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3206253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care